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David E. Marcinko [Editor-in-Chief]

As a former Dean and appointed Distinguished University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

Later, Dr. Marcinko was a vital recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.

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As readers and colleagues know, I’m a great fan of the Finnish culture, lifestyle and people. I’ve visited the country several times, touring and speaking, meeting with government, academia and local industry leaders and politicians in Helsinki, Tempere, Seinajori, Turku, Oulu and Northern Lapland, among other places; and especially Rovaniemi which is home to the world’s most northern branch restaurant of McDonald’s. Of course, the famed Arktikum there is also very comprehensive museum of arts, science and technology. Every time my wife and I visit, we learn more about the language, the arts and tradition.

Recent Visit to Finland

On our most recent month-long visit to Finland, we were able to visit a Japanese Honbu [karate gymnasium], meet several black-belt Taido karate students, and even take an actual class to stay in shape. I’ve been an avid runner for more than 30 years so aerobic cardio-vascular output was not-problematic. The trip was also remarkable for the many insights into the challenges of the Finnish healthcare system, their plans for eHRs and their emerging interest in American medical care. I’ve also made several friends and new colleagues, ingested cold raw dead-fish stew, and mastered the Finnish railway system. And so, my national healthcare service impressions follow; along with a bit more about the art and science of Taido styled karate.

Taido in Finland

Prior to our departure, we asked my daughter’s karate instructor, Sensei Uchida in Atlanta, GA, about the possibility of attending a Taido work-out in Finland. We were surprised when he informed us that the country has the largest number of Taido students in the world, second only to Japan. This interesting fact was later confirmed by the Finnish Athletic Association. The reason is that this form of exercise is covered under the country’s national health insurance system and is available to all citizens, free of charge. But, of course, income taxes are very high.

In fact, we learned that just the city of Helsinki itself, had nine Honbu’s to choose from and we selected what proved to be the most interesting, indeed! Another American instructor, Sensei Brent, mentioned that he visited the country a few years ago and still has some Taido friends from there, too.

The Taido Karate Honbu

Built during World War II to protect the population living in the City of Tempere from bombs, the Gymnasium in North East Helsinki is built into the side of a huge granite mountain, not unlike our own Stone Mountain here in Atlanta. Since it was originally constructed as an air-raid shelter during WW II, with many snaking corridors and smaller caverns, it is cool all year round with many miles of tunnels maintaining an even 56 degree temperature, just like natural underground caves. No air conditioning is needed for the short summers, and no heating system is needed for the very long winters.

Enter the Health Gymnasium

As we entered the “Health Gymnasium” as it was known, it was as if we were walking into a long tunnel through the woods, about 100 yards long. This entrance to the bomb shelter was really a railroad track line that was still visible after all these years. It was guarded by two huge iron doors several stories high. Inside, was a general reception area where we were directed to the actual Taido Honbu, itself, known as Budo # 6. As we walked through the long winding corridors, we noted that the walls were solid granite, painted white, and that each studio was separated only by a color-coded curtain; much like long rows with individual partitions. There was no graffiti and, although there was no sound-proof protection, the entire Gymnasium was surprisingly quiet.

A Linguistics Error

As we walked along, we noted studios for fencing, gymnastics, boxing and kickboxing, table tennis, ballet, weight lifting, volleyball, rowing and many different types of Karate and other martial arts, like Aikido, Bando Thaing, Capoei, Gatka, Hapkido, JuJitsu, Judo, Kendo, Kung Fu, Sumo and of course Tai Kwon Do. But alas, no Taido Honbu! We were horrified. Did we make a linguistic error! Was the term Taido misinterpreted as a generic terms for all these others types of martial arts or Karate forms? My daughter Mackenzie’s enthusiasm was crushed [after seven years of intensive study, with both national and international competition] as she is a black-belt candidate still in need of some teaching and karate internship credits to reach her ultimate goal. After-all, she brought her Gi [uniform] a long way to not to be able to use it. So, back to the reception area we went, inquiring again in our rudimentary Finnish. Fortunately, the problem was not a language faux-pau at all, but a one of timing. In our excitement, we had merely arrived an hour too early. Soon, the sign on one of the larger partitioned studios was changed to “TAIDO”, and students began filling-in, talking, laughing and giggling before class, just like they do in Atlanta.

Teaching Introductions

The class was comprised of blue, green and brown belt student [there are eight belt ranks], even though we took care to register for the same rank as daughter, Mackenzie. But, it was for about a dozen young adults, ages 18-30, and evenly split between guys and gals! No children. One student had been taking classes for about two years (she averaged 3-4 classes per week), while another was in his ninth year (able to participate only about once or twice per week). Nevertheless, Mac was agreeable to work-out with the adults, under the leadership of Sense Arie, who spoke English and was very cordial to us. When he then asked us what we had learned, we quickly listed Untai, Sentai and Hentai hokis [ritual movements; a Hoki is a pattern of techniques originally put together for mental and physical health and as a practice form of “free fighting.”], as he replied, “that will be sufficient for today”. No doubt, he and the other students were as curious about us, as we were about them. Introductions were made to all students, including moms, dads, grand-moms and grand-dads. We then settled down to watch Mackenzie and the class.

Class Comparisons

Like the Finnish healthcare system, the Taido karate class itself had several similarities and several differences compared to what we are used to, in Atlanta, GA.

1. First, the students and instructors wore the same colored GIs; solid black pants with roughly woven white tops. The GIs also were fancier with many epilates, patches and insignias. The belt color-coded system of the States was not used. Shoes were left outside, all bowed as a sign of respect upon entry, and lined up according to rank. There were no mirrors, horizontal warm-up bares, and virtually no padding in the mats on the floor! The epithet OUS, was replaced by a loudly shouted, EEEE!

2. Second, it was a longer class; an hour and a half, with a ten minute break in-between. Warm-ups were also longer and a bit more strenuous and aerobic orientated; running backwards, sideways and with lunges often performed in-between the hoki’s. But again, this was an adult class.

3. Third, the class was subdivided into smaller groups like our own, to practice kicks and punches initiated by sound or hand movement, as reaction-time was tested and improved. Mac’s partner had to kneel for her to reach his out-stretched hands, and she in turn had to raise her hands high overhead, as palms were used as targets. Her older partner worked with great diligence to best his younger opponent.

Finally, the ritualized hoki’s terminated a bit differently than our own, and they were performed much more slowly; almost ritualistically and with great concentration. And, form was a bit more casual than what were are used to, and not as sharp or precise as American Sensei Uchida or Sensei Matsuaki usually demands.

Health Status of Finlanders

Health services are available to all in Finland, regardless of their financial situation. Public health services are mainly financed from tax revenues. The child mortality rate in Finland is one of the lowest in the world; the infant mortality rate is below 4% and the life expectancy for a girl born now is 81 years, for a boy it is 73 years. Much like the US, the life expectancy of Finnish men has deteriorated by cardiovascular disease, excessive consumption of alcohol and accidents. Cardiovascular mortality has declined in response to effective health and nutritional education in recent decades but excessive blood cholesterol levels and obesity remain common in Finland. Smoking and drug abuse are significantly less frequent in Finland than in Europe on average. But, alcoholism and depression are national concerns because of the dark, prolonged and harsh winter climates. The aim of Finnish health policy is to lengthen the active and healthy lifetimes of citizens, to improve quality of life, and to diminish differences in health between population groups. Prevention receives particular emphasis in primary health care.

Finnish Healthcare System

The larger health care system in Finland is attracting international attention. For example, the European Observatory on Health Care Systems just launched a report examining Finland’s health system alongside that of other European countries. The system also has certain special features compared with systems in other countries. The main responsibility for organizing and financing health care is delegated to 448 local municipalities, which have exceptionally small and homogenous population bases, by US comparison. Another special feature is the existence of parallel financing and delivery systems alongside the municipal service system. The Finnish health care system survived the severe economic crisis of the 1990s fairly well, even though marked cuts were made in many public-sector budgets. As a result, it has emerged stronger today. The quantity and quality of health care services were largely maintained by improved management, efficiencies, electronic connectivity and resource allocation. A number of other initiatives are now developing in different directions.

Finnish Medical Association

On a more grass-roots level patient-care basis, the Finnish Medical Association [FMA] collaborates with various authorities and decision-making bodies in relation to the development of personalized medical care in Finland. It pursues patient initiatives and issues a number of statements each year with the aim of improving health care and related legislation, and puts forward plans to ensure a sound financial basis for provision of health services. For example, the national strike by physicians in 2001 drew national attention to the critical lack of resources provided for health care. The FMA plays a significant role in establishing a general patient insurance scheme and developing a family-doctor [US medical-home concept] system for Finnish health centers and practitioners. The Association promotes the rights of patients to have access to the treatment they need promptly. But, the possibilities for choosing a doctor and place of treatment need to be improved.

Contemporary Profile of a Health System in Transition

The Finnish healthcare system, much like the domestic healthcare system, is undergoing a period of reflection, modernization and reform. A special report, known as the Health Care Systems in Transition (HiT) series, profiles and analyzes the health care systems of over 40 European countries, Australia, Canada and the USA. The report for Finland was written by Ms Jutta Järvelin, Researcher at STAKES (the National Research and Development Centre for Welfare and Health), and in collaboration with the Finnish Ministry of Social Affairs and Health and the Observatory. STAKES is a center of expertise overseen by the Ministry of Social Affairs and Health.

On Finnish Longevity

Finnish super-centenarian Aarne Armas “Arska” Arvonen, the oldest Finnish male ever, just passed away at age 111 on January 1, 2009. He was the last living person in Finland who was born in the 1890s, and the third oldest man in Europe. He was also the seventh oldest man in the world. At the time of his death, Aronen was considered among the 20 oldest verified men to have ever lived in Europe.

Assessment

The formal report, Health Care Systems in Transition – Finland [Vol. 4, No 1. 2002]; Copenhagen, European Observatory on Health Care Systems, 2002 is available on the European Observatory on Health Care Systems website:

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

On this 2010 Memorial Day weekend, please allow us to directly reflect for a moment on the decline of the healthcare, banking and financial services industry in America. And; then somewhat indirectly comment on the hopeful emergence of the web 2.0 phenomena of which we all are a part. The competitive applicability to these sectors should be appreciated by the insightful ME-P reader.

Collapse of Command and Control Monopolies and Oligarchies

Old monopolies everywhere are crumbling because of tougher new competitors and the transparency wrought by electronic connectedness. For example, our old newspaper has to compete with the internet, your electric utility company battles low-cost local start-ups, telephone companies must begin installing fiber optic lines to fend off cable companies; and RIAs and fiduciary focused financial advisors [FAs] will supplant BDs and stock brokers in the financial services sector.

The airline industry collapsed a few years ago, the banking industry has just collapsed, and the auto industry is recovering as we pen this post. [We have a particular affinity for the auto sector however, as the son of a UAW member and step-daughter of Michiganders]. Regardless, the rush to more intense competition cannot be stopped. As a doctor, FA or other business competitor; you either keep pace or get crushed by quasi-oligarchic organizations like the American Medical Association [AMA], American Podiatric Medical Association [FPMA], American Dental Association [ADA], American Osteopathic Medical Association AOMA], Financial Planning Association [FPA], Certified Financial Planner Board of Standards [CFP BoS], College for Financial Planning [CFP] or the National Association of Personal Financial Advisors [NAPFA], etc. What have they, and Wall Street, done for you … lately? Scandal, taint, doubt, lost-credibility, a business-as-usual ennui, lethargy and ruin! Enter www.Sermo.com

In the last-generation of health insurance companies and related fraternal medical organizations, patients exercised great control over physician selection, had quicker access to specialists and encountered fewer restrictions on care. The reverse was true with financial services. But, because of advancing technology, aging demographics, intense R&D, global manufacturing, and escalating domestic HR costs – competitive market forces against traditional and structured staff model managed care companies – many industry analysts [like us] predicted growth would decline [Yes, greed was also involved as healthcare was presumed a recession-proof sector; and didn’t we all own behemoth big-pharma and HMO stocks in our 401-K, and 403-B plans]? But now, many former stock-brokers and FAs are going rogue; er – independent!

“Although inefficiencies in any business often open up in the short term, and can be greatly exploited by creative and visionary entrepreneurs – as in most business structures – market forces will prevail in the long run”.

Leo F. Mullin, MBA

[Former CEO – Delta Airlines]

Next-Gen with “Fly”

Fortunately, a new generation of enlightened physician and FA entrepreneurs is coming “out-of-the-shadows” as new-wave web 2.0 corporations and RIAs are becoming more flexible, competitive and market responsive. Simultaneously, monolithic and collectivist political ideas keep trying to regulate the medical and financial services workplace with rules, regulations and contracts to control entire populations. Yet, in the new healthcare economy, this new generation of doctors and FAs with “fly,” is headed toward more competition; not less – with more collaboration with patients and clients – regaining self autonomy.

Physician and FA Advocates

Meanwhile, as medical professionals, FAs and patient advocates, we must all choose between staying flexible to ride out tough times – or – adopting a hard, brittle line that will crack under the pressure of competition. We know where we stand at the ME-P, do you?

Flexibility and Virtual Reality

In recent years, many large corporations and top-down business models were not market responsive and change was not inherent in their DNA. These traditional organizations represented a rigid or “used-to-be” mentality, not a flexible or “wanna-be”mindset; according to business columnist Alan Webber. Somefinancial advisory corporations, and today’s emerging health 2.0 initiatives, may possess the market nimbleness that cannot be recreated in a controlled or collectivist [nationalistic] environment. And so, going forward, it is not difficult to imagine the following new rules for the new financial and virtual medical ecosystem.

[A] Rule No. 1

Forget about “SEC suitability and FINRA rules”, large office suites, surgery centers, fancy equipment, larger hospitals and the bricks and mortar that comprised traditional medical practices or financial product delivery systems. One doctor or niche focused FA with a great idea, good bedside manners or competitive advantage, can outfox a slew of public servants, the AMA, SEC, ADA or FINRA “faux copy-cat examiners”, while still serving the public – and patients – and making money. It’s now a unit-of-one economy where “Me Inc.”, is the standard. Physicians and FAs must maneuver for advantages that boost their standing and credibility among patients, peers, payers, customers and clients. Examples include patient satisfaction surveys; outcomes research analysis, evidence-based-medicine, physician economics credentialing and true integrated fiduciary-focused financial planning.

However, we should also realize the power of networking, vertical integration and the establishment of virtual RIAs or medical practices, which come together to treat a patient, or help a client, and then disband when a successful outcome is achieved. Job security is earned with more successful outcomes; not necessarily a degree, automatic AUMs, certifications or onsite presence. In fact, some competition experts, like Shirley Svorny PhD, a professor of economics and chair of the Department of Economics at California State University, wonder if a medical degree is a barrier – rather than enabler – of affordable healthcare.

Others even presume the establishment of virtual medical schools and hospitals, where students and doctors learn and practice their art on cyber-entities that look and feel like real patients, but are generated electronically through the wonders of virtual reality units. The same can be said for the financial services industry, although much farther down-line given its current slow rate of real education and quasi-professional acceptance.

[B] Rule No. 2

Challenge conventional wisdom, think outside the traditional box, recapture your dreams and ambitions, disregard conventional gurus and work harder than you have ever worked before. Remember the old saying, “if everyone is thinking alike, then nobody is thinking”. Do collective-nistas and nationalized healthcare advocates react rationally; or irrationally? [THINK: Wall Street, medical unions]

[C] Rule No 3

Differentiateyourself among your healthcare and financial advisory peers. Do or learn something new and unknown by your competitors. Market your accomplishments and let the world know. Be a non-conformist. Conformity is an operational standardand a straitjacket on creativity. Doctors and FAs should create and innovate, not blindly follow organization or political “union” leaders [shop stewards, BDs, etc] into oblivion.

[D] Rule No 4

Realize that the present situation is not necessarily the future. Attempt to see the future and discern your place in it. Master the art of the quick change with fast but informed decision making. Do what you love, disregard what you don’t, and let the fates have their way with you. Then, decide for yourself if you are of this ilk – and adhere to any of the above rules? Or, just become an employed [government, BD] doctor or FA shill. Just remember that the political party, or monopoly that can give you a job, can also take it away [THINK: LB, ML, Wachovia, national healthcare, etc].

Memorial Day Considerations

Finally, on this Memorial Day weekend, consider that life and career is a journey, and that in this country we have the choice to ponder or pursue any, and all of the above options, and more. We have the ability to think, cogitate and ruminate, as we have done here today. So – please – thank those who have helped turn this idealistic philosophy, into pragmatic daily reality.

For us personally, we thank Bonze Star Medal Winner Captain Cecelia T. Perez, RN. Now – ponder and consider – who do you thank? If no one has impacted you up-close on this Memorial Day weekend and national holiday, please visit our military channel to reflect, comment and opine.

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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In the late 1990s, the Dutch government started to experiment with ‘regulated competition’ in social health insurance. A milestone was the new Health Insurance Act in 2006 introducing a compulsory health insurance scheme for the entire population, carried out by (for-profit) health insurers, contracting individual and institutional health professionals. Safeguarding equal access, the new health insurance scheme introduced several preconditions like compulsory insurance, a basic benefit package, the prohibition of risk selection, a risk-equalization fund, etc. The idea of competitive health insurance was combined with deregulating hospital planning and liberalizing health care tariffs.

Merit Considerations

In the new scheme medical need is still decisive in health care access decision-making, but merit-considerations are becoming important too. Shortening waiting times, priority arrangements were considered and/or introduced, based on non-medical criteria. Simultaneously, in terms of financing, health status has become important due to own payments-arrangements, limited insurance package options, etc. At the same time, health status disparities due to socioeconomic inequalities seem to be increasing.

Under these circumstances, confronted with increased health spending, we can expect the “R” word becoming more eminent in the Dutch health care debate.

Relevant Rationing Questions

Emerging relevant questions are:

Who is responsible for rationing (markets, governments, bureaucrats, MDs or others)?

What is the relationship between rationing and differences in health status etc?

There is a wealth of literature in political theory, as well as in health care policy, economics, social medicine and law addressing these issues. What is needed is a consideration of the values involved, and the impact of, policy decisions on the expression of these values.

The Erasmus Observatory

Therefore, the Erasmus Observatory organized an international conference to discuss health care rationing from a wide range of perspectives.

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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As you know, the future of healthcare runs the risk of being taken over by the Government.

We must do all we can to prevent that from occurring.

Exercise your Franchise

So, please contact your Congressman and the Blue Dog Democrat Coalition, now. And, voice your opinion to those 58 members that hold the fate of Obama Care in their hands. They must understand what the constituents in their area and the country think about this issue.

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New Lewin Group Report Examines Potential Impact

[By Staff Reporters]

April 6, 2009

FALLS CHURCH, VA – The Lewin Group released a report titled “The Cost and Coverage Impacts of a Public Plan: Alternative Design Options.” The report examines potential impacts that a “public health plan” might have in competing for enrollment with the private insurance industry.

Healthcare Reform

As ME-P readers are aware, a public plan is currently being considered in a number of health reform proposals being considered by President Obama and the US Congress. This analysis enhances prior work done by The Lewin Group of the major party presidential candidate’s health reform proposals, during the 2008 campaign, as well as more recent analyses of the Congressional plans now being considered. The report estimates the impact on cost and coverage based on different levels of eligibility and reimbursement rates.

Key Findings Review

According to The Health Care Blog writer Robert Laszewski, key study findings include:

If Medicare payment levels are used in the public plan, premiums would be up to 30 percent less than premiums for comparable private coverage. On average, the monthly premium in the public plan for a typical benefits package would be $761 per family compared with an average of $970 per family in the private market for the same coverage.

If as the President proposed, eligibility is limited to only small employers, individuals and the self-employed, public plan enrollment would reach 42.9 million people. The number of people with private coverage would fall by 32.0 million people. If private payer reimbursement levels are used by the public plan, enrollment would be lower, with only 10.4 million people switching to the public plan from private insurance.

If the public plan is opened to all employers as proposed by former Senators Clinton and Edwards, at Medicare payment levels we estimate that about 131.2 million people would enroll in the public plan. The number of people with private health insurance would decline by 119.1 million people. This would be a two-thirds reduction in the number of people with private coverage (currently 170 million people). Here again, if the higher private payer levels are used, enrollment in private insurance would decline by only 12.5 million people.

Assuming Medicare reimbursement rates and eligibility for all individuals and employers, provider net income would decline under this public plan proposal, even after accounting for reduced uncompensated care and increased utilization for the newly insured. Net hospital revenues would fall by $36 billion (4.6 percent), and physician net income would fall by $33 billion (6.8 percent). If eligibility is restricted to individuals and small firms, net hospital revenues would actually increase by $11.3 billion due to the increase in newly insured individuals. But net physician incomes would decline by $3.0 billion.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

In this extended interview, Dr. Reinhardt, a leading adviser on health care economics and professor of political economy at Princeton University, compares the Canadian and American health care systems.

Reinhardt criticizes the US health care culture and expresses his optimism about the new Obama administration.

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Decide for yourself; is Uwe correct; or not? Why, or why not? Despite Democratic control, is healthcare reform even likely?

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Recent articles in the medical and lay press, this and other blogs, have focused on the growing shortage of primary care physicians in the United States. Of course, there is plenty of blame to go around; from Congress – to the AMA – to medical specialists and the CPT Coding Committee – the shortage is causing a crisis in the nation’s healthcare system.

A preventive medicine doctor commented on Medscape.com, January 2, 2009, “In the UK, whatever the defects of the system – and they are many – they build around GPs, who get $230,000 a year plus 25% performance bonuses. And, of course, they don’t have huge medical school debts.”

Assessment

In the US, [you] “have it backwards. The most valuable doctors — primary care physicians — get paid the least.”

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

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